Permit CITY OF TIGARD BUILDING PERMIT
111
COMMUNITY DEVELOPMENT Permit#: BUP2016-00143
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/17/2016
T[c.� t'jC? g Parcel: 1S135CC03900
Jurisdiction: Tigard
Site address: 10180 SW TIGARD ST
Project: Burt's Landing Subdivision: GREENBURG HEIGHTS ADDITION Lot: 8
Project Description: Demo permit for foundation only and capping of utilities of relocated house. Septic tank is to be pumped and filled
or removed. Upon final inspection credits for TDT,TTDT&PARKS will be available.
Contractor: GROW CONSTRUCTION LLC Owner: REAUME, JEFF&DEBORAH L
7900 SW HUNZIKER ST 16508 SW TIMBERLAND DR
TIGARD, OR 97223 BEAVERTON, OR 97007
PHONE: 503-597-2425 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: SF
Class of Work: DEM Type of Const: Permit Fee-Additions,Alterations, 05/17/2016 $149.75
Demolition
Occupancy Grp: Occupancy Load: Info Process/Archiving-Sm$0.50(up to 05/17/2016 $0.50
Dwelling Units: 0 11x17)
Stories: 0 Height: 0 ft Erosion Control w/Development 05/17/2016 $80.70
Bedrooms: 0 Bathrooms: 0
Value: $5,000
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $230.95
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 • eh OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23.1987 or 1.8 32.237
Iss d By: if. ) Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection c. e.
This permit card shall be kept in a conspicuous place on the job site until comp tion of the project.
Approved plans are required on the Job site at the time of each inspection.
Building Permit Application (l � �S / ,
E ' 11 3'I
Residential FOmil(l( I- t SF.O\I.I
City of Tigard Received a
Date/By: 7 I6 ..1 PennitNo.: C _��5� ///3
14 g 13125 SW Hall Blvd.,Tigard,O 2 2 r. Plan Review !l� UV!`i
Phone: 503.718.2439 Fax: 5tA1 0. 6() L 0Date/By: Other Permit:
I I G 1 l iInspection Line: 503.639.4175 . Date Ready/By: sl� Juns: ® See Page e 2 for
Internet: www.tigard-orgo+ 1 f‘ fit. ; dxr.pkl` Notified/Method / Supplemental Information ormation
41/26 Al Y
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4414
ei
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REQUIRED DATA:1-AND 2-FAMILY DWELLING
❑New construction J"'Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $
it I-and 2-family dwelling 0 Commercial/industrial `Jl poo
❑Accessory building ❑Multi-family Number of bedrooms:
❑Master builder ❑Other: Number of bathrooms: I2,
JOB SITE INFORMATION ANDLOCATION Total number of floors:
Job site address: /�7 b?Q StJ -7--,),../ Sf- New dwelling area: square feet
City/State/ZIP: .[ ;74, 0 _ �7 '-`Z 3 Garage/carport area: square feet
Suite/bldg./apt.no.: Project name: �L� �;� Covered porch area: square feet
Cross street/directions to job site: [ Deck area: square feet
7?";c4✓'k ,‘..I4 Ct- i14' .t S T Other structure area: square feet
REQUIRED DATA:COMMERCIAL-USE CHECKLIST
Subdivision: Lot no.: Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
P./1/14.0
. /2) . _®� ,A...-,....
Valuation: $
�/ 0 c[ Existing building area: square feet
G/57_,) New building area: square feet
0 PROPERTY OWNER 0 TENANT Number of stories:
Name: Type of construction:
Address: Occupancy groups:
City/State/ZIP: Existing:
Phone:( ) Fax:( ) New:
0 APPLICANT Of CONTACT PERSON BUILDING PERMIT FEES*
(Please refer to fee schedul)
Business name:
Structural plan review fee(or deposit):
Contact name: li,)0,1 I,,,,.1 F VIA,
Address: ,AlV:- FLS plan review fee(if applicable):
/J �`{' 7 -ZTotal fees due upon application:
City/State/ZIP: s4 Yy "Z3
Phone:(Su3 ) 7�)b,3._ (i- c3 3 Fax: :( ) Amount received: _—G--'
E-mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
Commercial and residential prescriptive installation of
CONTRACTOR roof-top mounted PhotoVoltaic Solar Panel System.
Business name: ,..1-ito,,,..) C-01/4.6`A,O`-�GJV�•, L, L Submit two(2)sets of roof plan with connection details
�+ and fire department access,along with the 2010 Oregon
Address: [ "'L Ig40 5„,... p_..\,0-_-„A__ 1fI,4Q Solar Installation Specialty Code checklist.
City/State/ZIP: 1-f((A,5 , 1 .L 3 Permit Fee(includes plan review $180.00
Phone: and administrative fees):
lS ' ) — � -- 77�FCj Fax:( ) State surcharge(12%of permit fee): $21.60
CCB lie.: si C F Z Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
��(C *Fee methodology set by Tri-County Building Industry
Print name: - Date: O Service Board.
l:ABuilding\Permits\BUP-RESPennitApp.doc 02/24/2011 440-4613T 1I/02/COM/WEB)
Building Permit Application Checklist
One- and Two-Family Dwelling FOR OIll( I. t SI. 0\I 1
City of Tigard Received
Date By: Permit No.:
II
13125 SW Hall Blvd.,Tigard,OR 97223 Associated permits:
II Phone: 503.718.2439 Fax: 503.598.1960
24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical
1 I(I A R I)
Internet: www.tigard-or.gov 0 Other:
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEWS les No y/1
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ • •
2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. 0 0 0
3 Verification of approved plat/lot. ❑ _ ❑ 0
4 Fire district approval required. Name of district: . 0 0 0
5 Septic system permit or authorization for remodel. Existing system capacity . 0 0 0
6 Sewer permit. ❑ 0 0
7 Water district approval. ❑ 0 0
8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 0 0
9 Erosion control 0 plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- ❑ 0 0
basin protection,etc.
10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state 0 0 0
building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if
copyright violations exist.
II Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if ❑ 0 0
there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals); location of easements
and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction
indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and
surface drainage.
12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size 0 0 0
and location.
13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, 0 0 0
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc.
14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- 0 0 0
floor,wall construction,roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings
and foundation,stairs,fireplace construction,thermal insulation,etc.
15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. 0 0 ❑
Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope.
Full-size sheet addendums showing foundation elevations with cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 ❑ ❑
prescriptive path analysis provide specifications and calculations to engineering standards.
17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ 0
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered 0 ❑ ❑
systems,see item 22."Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ 0 ❑
over 10 feet long and/or any beam/joist carrying a non-uniform load.
20 Manufactured floor/roof truss design details. 0 ❑ ❑
21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ ❑
for four or more appliances.
22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Ore on and shall be shown to be a licable to the ro'ect under review.
23 Three(3)site plans are required for item II above. Site plans must be 8-1/2"x 11"or 11-x 17". 0 0
24 Two(2)sets each are required for Items 16, 19,20 and 22 above. 0 0 ❑
25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ 0 0
26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale"indicates standard architect or engineer scale. ❑ 0 ❑
28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard 0 0 ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ 0
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I:1Building.Pennits`BUP-RESPennitApp.doc 02.24/2011 440-4613T(II/02(COM/WEB)
City of Tigard
COMMUNITY DEVELOPMENT DEPARTMENT
■
T 1 G A R D Building Permit Review — Residential
Building Permit #: 'VUPr-Pe (a—C10 /q 3
Site Address: _ /0/00 &' .c1S-
Project Name: �j-� J lo,e ,2),..4.,*,,y-- Lot #:
(New dydQfiing= subdivision name;.Addition or.Alteration= last name of owner)
Planning Review �Q
Proposal: ,�, m,� 4,0,64,-,- 0J¢- &---f.__
, Verify site address/suite# exists and actio to permit system.
I
pilover Terrace Neighborhood: No ❑ Yes,See River Terrace Review Addendum Attached
Sit,e Plan Elements:
VI ree (3) copies of site plan Existing structures on site
p/hrte plan must be on 8-1/2" x 11"or 11 x 17"paper � otprint of new structure(including decks)with finished
prawn to scale(standard architect or engineer scale) loor elevations
'orth arrow VJi tt locations(required for new,may apply for additions)
S. e address,project or subdivision name and lot number >cation of wells/septic systems
pplicant information (name and phone number) (Erosion control(including drainage-way protection,silt fence
L t dimensions and building setback dimensions d ign,location of catch basin,etc.)
1314 area,budding coverage area,percentage of coverage and reet names
pervious area(applicable if R-7,R-12,R-25&R-40) reet tree size,type and location
Property corner elevations (2 foot contour lines if more than Existing trees to lie retained with drip line,and tree
rm
e
4 foot differential) protection measures
Clean Water Services—Service Provider Lettey(lot platted prior to 9/10/1995):
13\ Required: E Yes,applicant was notified V No Received: ❑ Yes ❑ No
Public Facilities Improvement (PFI) Permit: /
equired: ❑ Yes,applicant was notified q�No Applied For: ❑ Yes El No,stop intake
and Use Case#: S Q(� &— W6
IVJ oning: P-4/ 6-
vSetbacks: Front „,90 Rear /s Side S Street Side A*. Garage c2(:.)
Landscape Requirement: °'o
Lot Coverage Maximum:
ISBuilding Height: Maximum Height Actual Height
Visual Clearance
Easements
Sensitive Lands: ❑ Yes ❑ No Type
Urban Forestry Plan
Conditions et"prior to suance f l;uilding permit
otes: , en a 7 jfl ni vn/
Approved By Planning: ,v,..,./. Date:Date: ON.
Revisions (after Building Submittal only) Reviewer Date
Revision 1: E Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: E Approved ❑ Not Approved
1:\Building\Forms\B1dgPermit Rvw_R ES_012116.docx
Building Permit Submittal �J
Original Submittal Date: /ac-! '
Site Plans: # 'J
Building Plans: #
Building Permit#: eiEnter building permit#above. ,�, ����
Workflow Routing: [Planning B'tngineering L�1'ermit Coordinator t
Workflow Sign-off: C'r-Sign-off for Planning(include notes from planning review)
Route Application Documents: ErEngineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
wilding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable, etc.
Notes: 1.---.),..12.-AAA-t) J
By Permit Technician: I . ' Date: 41/¢5-1 ` .6
Engineering Review
Slope at building pad:
Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes ❑ No
Assess Water Quantity Fee in-lieu: E Yes ❑ No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: fidR P Date: L., ...•A�, --,_
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved E Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
?::: DC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes N/A
Tigard Trans SDC: ❑ Yes 4/A
Parks SDC: ❑ Yes 7N/A
Ifi OK to Issue Permit
Approved by Permit Coordinator: Date: A'r/go
I:,Building yFonns,BldgPennitRvw_RES_0121 16.docx